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General NPI Number Information
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NPI Number | 1639390909
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Entity Type | Organization
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Legal Business Name | CHRISTIE E MATTER, MD PA
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 5805 COIT RD SUITE 203
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City | PLANO
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State | TX
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Zip | 75093-6989
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Country | US
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Telephone | 972-769-8180
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Fax |
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Provider Business Mailing Address
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Address Line | 5805 COIT RD SUITE 203
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City | PLANO
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State | TX
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Zip | 75093-6989
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Country | US
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Telephone | 972-769-8180
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Fax |
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | CHRISTIE E MATTER
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Credential | MD
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Telephone | 972-769-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K1187
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License Number State | TX
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